Hospitalizations Associated With Mental Health Conditions Among Adolescents in the US and France During the COVID-19 Pandemic
Authors: Alba Gutiérrez-Sacristán, Arnaud Serret-Larmande, Meghan R. Hutch, Carlos Sáez, Bruce J. Aronow, Surbhi Bhatnagar, Clara-Lea Bonzel, Tianxi Cai, Batsal Devkota, David A. Hanauer, Ne Hooi Will Loh, Yuan Luo, Bertrand Moal, Taha Mohseni Ahooyi, Wanjikũ F. M. Njoroge, Gilbert S. Omenn, L. Nelson Sanchez-Pinto, Andrew M. South, Francesca Sperotto, Amelia L. M. Tan, Deanne M. Taylor, Guillaume Verdy, Shyam Visweswaran, Zongqi Xia, Janet Zahner, Paul Avillach, Florence T. Bourgeois, James R Aaron, Giuseppe Agapito, Adem Albayrak, Giuseppe Albi, Mario Alessiani, Anna Alloni, Danilo F Amendola, François Angoulvant, Li L.L.J Anthony, Fatima Ashraf, Andrew Atz, Paula S Azevedo, James Balshi, Brett K Beaulieu-Jones, Douglas S Bell, Antonio Bellasi, Riccardo Bellazzi, Vincent Benoit, Michele Beraghi, José Luis Bernal-Sobrino, Mélodie Bernaux, Romain Bey, Alvar Blanco-Martínez, Martin Boeker, John Booth, Silvano Bosari, Robert L Bradford, Gabriel A Brat, Stéphane Bréant, Nicholas W Brown, Raffaele Bruno, William A Bryant, Mauro Bucalo, Emily Bucholz, Anita Burgun, Mario Cannataro, Aldo Carmona, Charlotte Caucheteux, Julien Champ, Jin Chen, Krista Y Chen, Luca Chiovato, Lorenzo Chiudinelli, Kelly Cho, James J Cimino, Tiago K Colicchio, Sylvie Cormont, Sébastien Cossin, Jean B Craig, Juan Luis Cruz-Bermúdez, Jaime Cruz-Rojo, Arianna Dagliati, Mohamad Daniar, Christel Daniel, Priyam Das, Audrey Dionne, Rui Duan, Julien Dubiel, Scott L DuVall, Loic Esteve, Hossein Estiri, Shirley Fan, Robert W Follett, Thomas Ganslandt, Noelia García-Barrio, Lana X Garmire, Nils Gehlenborg, Emily J Getzen, Alon Geva, Tomás González González, Tobias Gradinger, Alexandre Gramfort, Romain Griffier, Nicolas Griffon, Olivier Grisel, Pietro H Guzzi, Larry Han, Christian Haverkamp, Derek Y Hazard, Bing He, Darren W Henderson, Martin Hilka, Yuk-Lam Ho, John H Holmes, Chuan Hong, Kenneth M Huling, Richard W Issitt, Anne Sophie Jannot, Vianney Jouhet, Ramakanth Kavuluru, Mark S Keller, Chris J Kennedy, Kate F Kernan, Daniel A Key, Katie Kirchoff, Jeffrey G Klann, Isaac S Kohane, Ian D Krantz, Detlef Kraska, Ashok K Krishnamurthy, Sehi L'Yi, Trang T Le, Judith Leblanc, Guillaume Lemaitre, Leslie Lenert, Damien Leprovost, Molei Liu, Qi Long, Sara Lozano-Zahonero, Kristine E Lynch, Sadiqa Mahmood, Sarah E Maidlow, Adeline Makoudjou, Alberto Malovini, Kenneth D Mandl, Chengsheng Mao, Anupama Maram, Patricia Martel, Marcelo R Martins, Jayson S Marwaha, Aaron J Masino, Maria Mazzitelli, Arthur Mensch, Marianna Milano, Marcos F Minicucci, Jason H Moore, Cinta Moraleda, Jeffrey S Morris, Michele Morris, Karyn L Moshal, Sajad Mousavi, Danielle L Mowery, Douglas A Murad, Shawn N Murphy, Thomas P Naughton, Carlos Tadeu B Neto, Antoine Neuraz, Jane Newburger, Kee Yuan Ngiam, James B Norman, Jihad Obeid, Marina P Okoshi, Karen L Olson, Nina Orlova, Brian D Ostasiewski, Nathan P Palmer, Nicolas Paris, Lav P Patel, Miguel Pedrera-Jiménez, Ashley C Pfaff, Emily R Pfaff, Danielle Pillion, Sara Pizzimenti, Tanu Priya, Hans U Prokosch, Robson A Prudente, Andrea Prunotto, Víctor Quirós-González, Rachel B Ramoni, Maryna Raskin, Siegbert Rieg, Gustavo Roig-Domínguez, Pablo Rojo, Paula Rubio-Mayo, Paolo Sacchi, Elisa Salamanca, Malarkodi Jebathilagam Samayamuthu, Arnaud Sandrin, Nandhini Santhanam, Janaina CC Santos, Fernando J Sanz Vidorreta, Maria Savino, Emily R Schriver, Petra Schubert, Juergen Schuettler, Luigia Scudeller, Neil J Sebire, Pablo Serrano-Balazote, Patricia Serre, Mohsin Shah, Zahra Shakeri Hossein Abad, Domenick Silvio, Piotr Sliz, Jiyeon Son, Charles Sonday, Anastasia Spiridou, Zachary H Strasser, Bryce WQ Tan, Byorn WL Tan, Suzana E Tanni, Ana I Terriza-Torres, Valentina Tibollo, Patric Tippmann, Emma MS Toh, Carlo Torti, Enrico M Trecarichi, Andrew K Vallejos, Gael Varoquaux, Margaret E Vella, Jill-Jênn Vie, Michele Vitacca, Kavishwar B Wagholikar, Lemuel R Waitman, Xuan Wang, Demian Wassermann, Griffin M Weber, Martin Wolkewitz, Scott Wong, Xin Xiong, Ye Ye, Nadir Yehya, William Yuan, Alberto Zambelli, Harrison G Zhang, Daniela Zöller, Valentina Zuccaro, Chiara Zucco
Journal: JAMA Network Open (2022)

Importance The COVID-19 pandemic has been associated with an increase in mental health diagnoses among adolescents, though the extent of the increase, particularly for severe cases requiring hospitalization, has not been well characterized. Large-scale federated informatics approaches provide the ability to efficiently and securely query health care data sets to assess and monitor hospitalization patterns for mental health conditions among adolescents. Objective To estimate changes in the proportion of hospitalizations associated with mental health conditions among adolescents following onset of the COVID-19 pandemic. Design, Setting, and Participants This retrospective, multisite cohort study of adolescents 11 to 17 years of age who were hospitalized with at least 1 mental health condition diagnosis between February 1, 2019, and April 30, 2021, used patient-level data from electronic health records of 8 children’s hospitals in the US and France. Main Outcomes and Measures Change in the monthly proportion of mental health condition–associated hospitalizations between the prepandemic (February 1, 2019, to March 31, 2020) and pandemic (April 1, 2020, to April 30, 2021) periods using interrupted time series analysis. Results There were 9696 adolescents hospitalized with a mental health condition during the prepandemic period (5966 [61.5%] female) and 11 101 during the pandemic period (7603 [68.5%] female). The mean (SD) age in the prepandemic cohort was 14.6 (1.9) years and in the pandemic cohort, 14.7 (1.8) years. The most prevalent diagnoses during the pandemic were anxiety (6066 [57.4%]), depression (5065 [48.0%]), and suicidality or self-injury (4673 [44.2%]). There was an increase in the proportions of monthly hospitalizations during the pandemic for anxiety (0.55%; 95% CI, 0.26%-0.84%), depression (0.50%; 95% CI, 0.19%-0.79%), and suicidality or self-injury (0.38%; 95% CI, 0.08%-0.68%). There was an estimated 0.60% increase (95% CI, 0.31%-0.89%) overall in the monthly proportion of mental health–associated hospitalizations following onset of the pandemic compared with the prepandemic period. Conclusions and Relevance In this cohort study, onset of the COVID-19 pandemic was associated with increased hospitalizations with mental health diagnoses among adolescents. These findings support the need for greater resources within children’s hospitals to care for adolescents with mental health conditions during the pandemic and beyond.